Provider Demographics
NPI:1275079709
Name:COX, CATHERINE (RN WCCM)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:RN WCCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13618 BARDON RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1518
Mailing Address - Country:US
Mailing Address - Phone:410-627-0728
Mailing Address - Fax:
Practice Address - Street 1:13618 BARDON RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1518
Practice Address - Country:US
Practice Address - Phone:443-509-2701
Practice Address - Fax:717-795-6204
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-08
Last Update Date:2017-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186117163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse